AN ACT CONCERNING RESTRICTED ACCESS TO PRESCRIPTION DRUG INFORMATION.

This bill restricts access to certain prescription drug information. It prohibits pharmacy benefit managers, pharmacies, health insurers, or any of their employees or agents from transferring, selling, or sharing, for any commercial purpose, prescription drug information if it contains individually identifiable information concerning the patient or the prescribing practitioner.

The bill does not prohibit the use, transmission, or transfer of prescription information in certain specified situations.

A violation of the bill's provisions is deemed an unfair or deceptive practice under the Connecticut Unfair Trade Practices Act (CUTPA). The bill also makes a violation by a health insurer an unfair insurance practice.

The bill defines “commercial purpose” to include advertising, marketing, promoting, or any activity that could be used to (1) influence the sales or market share of a pharmaceutical product, (2) influence or evaluate the prescribing behavior of an individual health care provider, or (3) evaluate the effectiveness of a professional pharmaceutical detailing sales force. (Detailing, in this context, generally refers to the use of targeted marketing and sales visits by pharmaceutical representatives based on the data pharmaceutical companies obtain about prescription practices. )

Commercial purpose, under the bill, does not include the use of prescriber identifiable data by a professional physician organization for purposes of education and evaluation by individual members.

The bill defines “pharmacy” as a place of business with a pharmacy license where drugs and devices may be sold at retail and includes a nonresident pharmacy (a pharmacy outside the state which ships, mails, or delivers legend devices or legend drugs into the state according to a prescription order; “legend drug” or “legend device” is any drug or device that requires a prescription).

A “pharmacy benefits manager” is any person administering the prescription drug, device, or pharmacist services portion of a health benefit plan on behalf of plan sponsors (e. g. , self-insured employers, insurance companies, labor unions, and health care centers).

Under the bill, “health insurer” means any entity, including a managed care organization, that delivers, issues for delivery, renews, or amends an individual or group health plan in the state.

The bill defines “managed care organization” as an insurer, health care center (HMO), hospital, medical service corporation, or other organization delivering, issuing for delivery, renewing, or amending any individual or group health managed care plan in the state.

The bill does not prohibit (1) dispensing prescriptions to a patient or the patient's authorized representative; (2) transmitting prescription information between an authorized prescriber and a licensed pharmacy; (3) transfer between licensed pharmacies; (4) transferring prescription records if pharmacy ownership changes or transfers; (5) giving information to a patient about a health condition, adherence to a prescribed course of therapy, or other information about the drug dispensed, treatment options, or clinical trials; (6) collecting, using, transferring, or selling patient and prescriber data, by zip code, geographic region, or medical specialty for commercial purposes, as long as it does not identify individuals; (7) transferring or sharing prescription information for purposes of receiving health insurer reimbursement, formulary compliance, care management, utilization review by a health care provider or patient's insurance provider or agent, health care research, or as otherwise provided by law (but any person receiving information in this manner must not disclose it except as authorized); and (8) collecting, using, transferring, or selling prescription records (a) to a third party solely for facilitating notice to patients or providers of a pharmaceutical recall or warning issued by the federal Food and Drug Administration or (b) for assisting a prescribing practitioner with provider identified information concerning only his or her prescribing history and nonidentifiable information concerning other practitioners' prescribing history.

This law prohibits businesses from engaging in unfair and deceptive acts or practices. CUTPA allows the Department of Consumer Protection commissioner to issue regulations defining what constitutes an unfair trade practice, investigate complaints, issue cease and desist orders, order restitution in cases involving less than $ 5,000, enter into consent agreements, ask the attorney general to seek injunctive relief, and accept voluntary statements of compliance. Courts may issue restraining orders; award actual and punitive damages, costs, and reasonable attorney's fees; and impose civil penalties of up to $ 5,000 for willful violations and $ 25,000 for violation of a restraining order. CUTPA also allows individuals to sue.

The law prohibits engaging in unfair or deceptive insurance acts or practices. CUIPA authorizes the insurance commissioner to issue regulations to implement the act, conduct investigations and hearings, issue cease and desist orders, ask the attorney general to seek injunctive relief in superior court, impose fines, revoke or suspend licenses, and order restitution.

Fines may be up to (1) $ 5,000 per violation to a $ 50,000 maximum, or (2) $ 25,000 per violation to a $ 250,000 maximum in any six-month period if knowingly committed. The law also imposes a fine of up to $ 50,000, in addition to or in lieu of a license suspension or revocation, for violating a cease and desist order.

Yea

Nay

(03/20/2009)